Lung Cancer Flashcards
(27 cards)
2 main pathways of carciogenesis?
In the lung periphery, bronchioloalveolar cells transform = adenocarcinoma.
In the central lung, bronchial epithelial stem cells transform = squamous cell carcinoma.
Risk factors of lung cancer?
Male Smoker Occupational Pollution Radiation (radon) Asbestos Pulmonary fibrosis
What are the two main subdivisions of lung tumours? How are they divided? Why are they divided?
Small cell carcinoma
Non small cell carcinoma
Divided based on the histological appearances of the cells
Divided because they behave differently and can be treated differently
What is non-small cell further divided into?
squamous cell
adenocarcinoma
large cell carcinoma
Squamous cell carcinoma features?
Arises from epithelial cells.
Can cause obstructive lesions of bronchus, leading to infection.
Large cell features?
Poorly differentiated
Symptoms of lung cancer? When do they show?
Show when disease is advanced
cough haemoptysis weight loss dyspnoea chest pain recurrent chest infections wheeze / hoarse voice / dysphalgia (difficult to swallow)
Signs of lung cancer?
Clubbing Lymphadenopathy Superior vena cava obstuction hepatomegaly tracheal deviation
When does a cough merit an x-ray?
3 weeks
What causes dyspnoea and wheeze?
Tumours can cause AFO
Why blood in cough?
Tumour bleeds into airway
Why chest pain?
Peripheral tumors invade pleura
Why a hoarse voice?
Tumour invasion of the mediastinum results in compression of the left recurrent laryngeal nerve.
What causes the muscle wasting and nerve compression in arm?
Pancost tumours in lung apex invades brachial plexus
What causes horners syndrome
compression of the sympathetic chain
Why recurrent infections?
Tumour AFO results in post-obstructive pneumonia.
Common met sites?
Liver Bone Brain Adrenal glands Lymph nodes Kidney Pleura
What does mets to the pleura cause?
Malignant pleural effusion
What investigations are used to diagnose and stage lung cancer?
CxR
Bronchoscopy
CT/PET CT
MRI
What is the lung cancer staging system?
TNM
Primary tumour
Regional lymph nodes
Distant mets
These are all taken into account and the overall cancer is staged up to stage 4.
What does T mean and how is it scored?
T - Primary Tumour
Scored between TX/T0 to T4, depending on the size and invasion of the tumour.
What does N mean and how is it scored?
N - Regional Lymph Nodes
Scored between NX/N0 to N3 depending on invasion of the nodes.
What does M mean and how is it scored?
M - Distant Metastases
Scored between M0 and M1 depending on the present of mets.
When is surgery is used to treat lung cancer?
Used in Non small cell - stages 1,2 and maybe sometimes 3A
Never if mets
